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Shielding Parenteral Nutrition Solutions From Light: A Randomized Controlled Trial.

Sophie Laborie1, Angélique Denis2, Gilles Dassieu3

  • 1Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France Hospices Civils de Lyon-Centre Hospitalier Lyon Sud, Pierre-Bénite, France sophie.laborie@gmail.com.

JPEN. Journal of Parenteral and Enteral Nutrition
|June 14, 2014
PubMed
Summary

Full light protection of parenteral nutrition (PN) did not reduce bronchopulmonary dysplasia (BPD) or death in very low-birth-weight infants. However, all-in-one PN infusion was associated with a lower BPD/death rate, warranting further study.

Keywords:
bronchopulmonary dysplasiaparenteral nutritionperoxidespreterm infantvery low birth weight

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Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Biochemistry

Background:

  • Oxidant stress contributes to bronchopulmonary dysplasia (BPD) pathogenesis.
  • Parenteral nutrition (PN) solutions generate peroxides when exposed to light, increasing oxidant stress.
  • Shielding PN from light has shown nutritional and biochemical benefits in preclinical and clinical studies.

Purpose of the Study:

  • To investigate if full light protection of PN reduces the incidence of BPD or death in very low-birth-weight infants.
  • To evaluate the impact of photoprotection on clinical outcomes in preterm neonates.

Main Methods:

  • A multicenter randomized controlled trial was conducted.
  • Infants received either light-protected (LP) or light-exposed (LE) PN.
  • Infants were born before 30 weeks gestational age.

Main Results:

  • No significant difference in BPD/death rates was observed between the LP and LE groups at 28 days or 36 weeks corrected age.
  • Multivariate analysis did not reveal a significant effect of photoprotection on BPD/death.
  • A significantly lower rate of BPD/death was found in infants receiving all-in-one PN compared to those receiving lipids separately.

Conclusions:

  • Full light protection of PN did not demonstrate significant benefits in reducing BPD or death in this cohort.
  • The observed benefit of all-in-one PN on BPD/death rates may be center-dependent and requires further investigation.